MRI reveals brachial plexus lymphoma mimicking plexopathy

Diffuse T2/STIR hyperintensity and thickening of brachial plexus with marrow infiltration on MRI suggested lymphoma in a 32-year-old man with rapidly progressive brachial plexopathy. Biopsy confirmed Stage IV high-grade B-cell lymphoma; chemoimmunotherapy led to recovery.

• MRI showed diffuse thickening and T2/STIR hyperintensity of distal brachial plexus divisions, cords, and branches, with contiguous humeral marrow and soft tissue infiltration.
• Bone marrow biopsy confirmed Stage IV high-grade B-cell lymphoma with high proliferative index.
• R-CHOP chemoimmunotherapy resulted in significant clinical and neurological improvement.

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